OPM Disability Retirement Help: Different Standards

To overdress is almost always acceptable; to underdress — well, while it may be acceptable, you may have to endure being the subject of curiosity and quiet whispers of raised eyebrows.

There are different standards for every occasion, endeavor, event or engagement; some high, others low; a few enforced without exception while still maintaining a sense of decorum and the rest of them left to ignored apathy where anything goes.  Some private clubs seem to thrive upon the exclusivity of standards maintained so high that few can meet the exceptionalism applied, while those more accessible to the public allow for flagrant violations with nary a nod or a wink.

It is when the context becomes the content that eyebrows become raised, and the higher the brow the more exclusive the thinking.  For the rebel, it is always difficult to try and convey the notion that one must adapt and change with the circumstances — that standards are applied, and you must recognize those standards and act accordingly.

For Federal employees and U.S. Postal workers who suffer from a medical condition such that the standards set have now failed to be met — whether at the personal level or the professional — it might be time to consider filing for Federal Disability Retirement benefits, whether the Federal or Postal employee is under FERS, CSRS or CSRS Offset.

Whether through a recognition of the standards set for yourself — which is often higher than what is acceptable by others — or because you are beginning to get the hints that your agency or the Postal Facility has become dissatisfied with your work performance, your attendance or excessive use of sick leave; whatever the reason, the plain fact is that the medical condition itself is always the basis for determining the need to alter and modify one’s personal and professional standard.

Don’t be too hard on yourself.  The standard you used to apply before the onset of a medical condition should not be the same one that is applied to your present situation, and you should therefore consider that the standard of maintaining one’s health is the present priority exclusively, no matter what your Federal Agency or your Postal Facility tries to have you believe.

Consult with an attorney who specializes in Federal Disability Retirement Law, and determine whether you “meet the standards” to apply for Federal Disability Retirement benefits through the U.S. Office of Personnel Management.  They may be different than what you think.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Independent Entities

If Federal agencies were created with the proverbial single “stroke of the pen”, all at once, in unison and coordinated intersections of thoughtful complexities, then of course there would be a lack of overlap, duplication and repetition. The essence of efficiency is precisely to limit duplicative efforts. But then, some would perhaps say that it is an inherent self-contradiction to assert that Federal agencies can both be coordinated as well as efficient.

In the disability compensatory systems impacting Federal and Postal workers, there are multiple “pockets” which the Federal and Postal worker can be eligible for, given the right qualifications and by meeting certain threshold criteria. Under FERS, the system of retirement and disability retirement was fairly well-planned (and, again, some would say that such planning was a historical first, in many ways), in that it envisioned a coordination of benefits between the retirement system and Social Security. That is precisely why, in filing for Federal Disability Retirement benefits under FERS, the Federal or Postal employee must also file for Social Security Disability Insurance benefits sometime during the process.

Then, of course, there are a multitude of other programs and agencies, such as VA benefits (for Veterans of the military services) and OWCP/FECA, for “on-the-job” injuries. Each are independent entities, created for specific purposes, goals and targeted personnel.

Over the years, the Courts, and specifically the U.S. Merit Systems Protection Board, have somewhat “clarified” the interconnecting impact of a decision from one independent agency upon the decision-making process of another, and such decisions should be used in arguing one’s Federal Disability Retirement case.

Benefit coordination, offsets and simultaneous filings aside, how one utilizes the decision of one administrative agency in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is an important component in reaching the goal of a successful Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Standards

The existence of a standard constitutes an irrelevancy if the application of it is based upon an unknowable, incalculable methodology.  Standards represent a paradigm which, if implemented, provide for stability and consistency, precisely because one can rely upon the same application in all instances, and indeed, that is what is often defined as “fairness”.

Thus, in sports — if the referee makes all calls based upon a known standard, there is very little to argue with respect to the “rules”; one may, of course, challenge the interpretation of the “facts” and charge that the referee is blind and did not see the play as reality reflected; but no one can argue the minutiae of the standard itself.  In society, and in a civilization governed by rules and accepted procedures of administration, if a standard is disagreed upon, then a democratic method of change is normally considered an appropriate methodology of redefining the lines previously demarcated by the “old” standard.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is assumed that the standard which would constitute “fair play” will be one of “preponderance of the evidence”, but the actual implementation of such a legal standard will necessarily depend upon whether the Case Worker at OPM actually understands what that standard means.

It is, ultimately, a low civil “bar” to meet; and when a denial is rendered, the language contained within the denial will often reveal the extent of comprehension on the part of the OPM Case Worker.  Pointing a misapplication of the standard is sometimes a useful tool in taking the Federal Disability Retirement case to the next level — the Reconsideration Stage of the process — but unduly focusing upon the mistakes of the previous Case Worker is often a waste of time.

Balance is the key; application of the correct standard is vital to the working efficiency of a bureaucracy; pointing out a misapplication is why attorneys exist.  They are, ultimately, technicians of written standards.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Proving with Purposive Intent

Each compensatory program, whether on a Federal, State or Local level, has an underlying basis which finds its inception in an idea, a proposal, then a statute.  The statutory authority of a “program” is the basis of its very existence.  Court opinions will interpret, expand upon, and “explain” the limits and boundaries of the program itself.

As such, each program of compensation contains a “raison d’être” (a reason for its very existence), and in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, it is often a good idea to understand the foundational basis of a compensation program, in order to be able to effectively attack it, comply with it, and ultimately to prove its purposive intent.

Thus, for Social Security Disability, for example, the underlying purposive intent involves a higher standard of “total disability” and how the medical condition impacts one’s daily living activities.  For the Department of Labor, Federal Employees’ Compensation Act (DOL/FECA), the underlying purposive intent involves an injury or medical condition related to the job itself, with a view towards (if at all possible) rehabilitating the Federal or Postal employee such that he or she can return to the position occupied prior to the injury.  For Federal Disability Retirement under FERS or CSRS, it is the “bridge” itself which defines the purposive intent — of the impact between the medical condition and the particular job which one performs.

It is for that very reason — the purposive intent behind a Federal Disability Retirement Statute — that the compensation program allows for the Federal or Postal employee, unlike the other programs, to go out and earn up to 80% of what one’s former position currently pays, in addition to receiving the Federal Disability Retirement annuity.

By understanding, one is able to begin to formulate a strategy of applying and proving a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Logic versus Pragmatic Social Policy

In a Federal Circuit Court case a few years ago, a dissenting opinion concerning Federal Disability Retirement benefits argued that it was “contrary to logic” to allow for Federal or Postal employees to become eligible for Federal Disability Retirement under FERS or CSRS if they have been accorded light duty and allowed to remain in his or her official position while not performing many of the essential elements of the job.  

The “logic” which is argued here is based upon the paradigm that, so long as one is allowed to continue to work and receive a paycheck, one should not be considered “disabled”.  But such an argument refuses to acknowledge both the law (under the Bracey v. OPM decision), as well as good economic and social policy.  

The fact is that under Federal Disability Retirement rules, laws and case-laws, what the Administrative Judges and Courts have acknowledged is that a Federal or Postal worker should not be subjected to the arbitrary whims and actions of a single supervisor or Agency; instead, there should be a criteria upon which a Federal or Postal worker should be able to rely upon.  That objective criteria is in essence as follows:   A Federal or Postal worker should have to perform all of the essential elements of one’s job.  If not, that Federal or Postal worker is deemed “disabled” under the laws governing Federal Disability Retirement benefits.  

While an Agency may allow for light duty, or temporary assignments, such light duty or temporary assignments should not preclude the obvious fact that the Federal or Postal worker continues to remain disabled.  This way, there is an objective criteria of the law to be followed, which cannot be altered based upon the arbitrary whim of a Supervisor or an Agency, who may come along a year later and disallow all light duties or temporary assignments.  Thus, in this case, the social and economic policy as envisioned under the Federal Disability Retirement rules, regulations and laws, are not only pragmatic, but logical.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Burden of Proof

In preparing, formulating and filing a Federal Disability Retirement application under FERS & CSRS, one is often asked (and should also ask of one’s self) the following question:  What does it take to be eligible?  What proof proves my case?  How much proof must I submit (quantity) and is the proof I submit sufficient (quality)?  All of these questions fall under a generic rubric in law, termed as “burden of proof“. 

Every legal process — and filing for Federal Disability Retirement benefits under FERS or CSRS is no different — applies a legal standard:  a set of criteria in determining whether or not a Federal or Postal Worker is eligible for — qualifies for — Federal Disability Retirement benefits under FERS or CSRS. 

In applying a statutory set of criteria, there is the general application of what constitutes, or meets the needs of, the evidence, documents, and proof that is submitted for review.  The overriding standard that is supposed to be applied for determining the process, is a standard of law called, “Preponderance of the evidence.”  It is a relatively low standard used in civil law — where, if the proof submitted shows that it is more likely so than not so, then one has met “by a preponderance of the evidence” that a Federal or Postal employee is entitled to Federal Disability Retirement benefits. 

Does this standard apply at the administrative level — at the Office of Personnel Management?  The answer is “Yes”, but not necessarily consciously.  One only effectively argues that the standard of proof has been met when one encounters a Judge — at the Merit Systems Protection Board.  But, nevertheless, OPM is supposed to follow “the law” and the burden of proof, and it is simply one more argument that one can, and should, make to the Office of Personnel Management when filing for Federal Disability Retirement benefits under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: Differing Legal Criteria

Similar benefits, at the State, Local, Private levels, and at the Federal level, each contain differing legal criteria for eligibility. Thus, for instance, Social Security Disability benefits require one set of standards of eligibility; private disability insurance policies require a different set of standards; and state disability benefits often differ from state to state.  This is of course true of Federal Disability Retirement benefits under FERS and CSRS — where the legal standard of eligibility is different from Social Security, Worker’s Comp, and State or private disability criteria.

Often, a question is asked whether a medical narrative report which is prepared for submission to the Office of Personnel Management can be used for submission for other “similar” benefits.  The short answer is, “It all depends”, but the long answer is that, in most cases, one must be very cautious.  When I represent a Federal or Postal employee under FERS or CSRS, one of the first steps in preparing a viable case is to request of the treating doctors a detailed medical narrative report.  One must understand that the treating doctor has, generally speaking, next to no idea as to the legal criteria that must be met under FERS or CSRS.  Furthermore, the treating doctor has no legal knowledge as to the differences between private disability insurance policies, State, Social Security, OWCP or FERS & CSRS.  It is the job of the Attorney to make sure and guide the treating doctors as to the criteria which must be met as to the particular and specialized field for which the medical narrative is being prepared.  This must be done with care, and with detailed guidance.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Don't Confuse the Standards

People who call me for advice, who are potential candidates as clients for Federal Disability Retirement benefits under FERS or CSRS, often interchangeably use terms which apply to different standards:  standards of total disability as opposed to a medical disability which impacts one’s ability to perform one or more of the essential elements of one’s job; whether a medical condition is an “accepted” disability (a concept which is often used in Social Security disability cases); whether a person can file for Federal Disability Retirement benefits even though he “hasn’t reached MMI” (“Maximum Medical Improvement”) — which is language encompassing a concept familiar to OWCP/DOL (Worker’s Comp) cases; or, on a different level, the statement that an agency has been “accommodating” an employee by allowing him/her to take sick leave, Leave Without Pay, or to “not have to travel as much” — mistakenly or loosely using the term “accommodation”, when in fact such agency actions do not constitute a legally viable accommodation, as that term is used in Federal Disability Retirement laws. 

It is the job of the attorney to correct, clarify, and otherwise explain the proper terminology and precise application of concepts in Federal Disability Retirement cases.  It is not surprising that people who are contemplating filing for Federal Disability Retirement benefits under FERS or CSRS use the various terms in error, or mix terms unknowingly — for there is alot of misinformation “out there”; it is the job of an Attorney who specializes in Federal Disability Retirement law to clarify such confusions.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Problems with the OWCP Paradigm

The problem with basing one’s future stability upon an “OWCP Paradigm”, or “model”, are multiple in nature.  To begin with, you cannot work at another job while receiving OWCP temporary total disability payments.  Thus, while you may be an injured worker, and unable to perform the essential elements of your Federal or Postal job, you may nevertheless be able to be productive in some other capacity, and may be capable of starting a business or working in some other field.  This is true if you are on OPM Disability retirement:  You can go out and get another job, and make up to 80% of what your former position currently pays, and continue to receive your disability annuity.  This is a good deal, in my view, because it provides an incentive to go out and become productive, and to plan for the future. 

Furthermore, OWCP/Department of Labor is notorious for cutting off benefits at the first sign that you are anything less than fully cooperative with their dictates.  OWCP may send you to a “second opinion” doctor who finds that you are “completely recovered”, thereby endangering your Worker’s Comp benefits.  Or, in order to save money, they may dictate to you that you must work as a Wal-Mart greeter, and pay you the difference between a menial job (not of your choice) and what they are paying you.  If you refuse, OWCP may simply ascribe what they believe you can earn, and pay you the difference — or not pay you anything.  While OWCP has procedures for appealing decisions, it is a long and arduous road to take.

These are only some of the problems associated with basing one’s future upon a Worker’s Compensation paradigm.  That is not to say that one should not file for and accept OWCP payments — it definitely pays more, and for a temporary period of payments in order for an injured Federal or Postal employee to remain financially solvent in order to recover from one’s work-related injuries, it is a good program.  As a paradigm for planning for one’s future, however, there is much to be desire.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: SSA Approval, Part I

Of interest is what to do when a Social Security filing for disability benefits has been approved prior to the FERS/CSRS disability retirement application being approved.  This is a rarity, and indeed, it should logically be that way:  for Social Security disability requires a higher standard of (essentially) “total disability”; while the criteria for approval under FERS/CSRS is that of an “inability to perform the essential elements” of a particular job — meaning, in essence, that an individual is no longer a good fit for a particular type of job, but could certainly be productive in some other capacity of employment.

The cases at the Merit System Protection Board which have addressed this issue have been fairly consistent.  An approval in and of itself will not necessarily help a FERS/CSRS application; as with the application process itself, the applicant has the preponderance of the evidence of proving the relevance of the approved Social Security filing.  I am often asked whether, in a denial of an SSA disability application, where the decision by the Social Security Administration states that, while SSA acknowledges that the applicant is unable to perform his or her current employment because of the medical condition, yet the applicant for SSA disability benefits is denied because he or she may engage in other productive employment — whether such a statement in the denial (that SSA acknowledges the applicant’s inability to perform his or her current job) should be forwarded to OPM.  My answer is that it should not be, because it is not relevant to OPM’s criteria for making a determination.

As to the two most important questions:  1.  If a Social Security Disability application is approved, what needs to be sent to OPM, and 2. If Social Security’s determination doesn’t provide the necessary language to be relevant for forwarding to OPM, what can take its place?  As to these two questions, I will be addressing each in a blog to be written in the very near future.

Sincerely,

Robert R. McGill, Esquire